| NPI | 1013942135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: VA 0101034633) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101034633) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2024-10-03 |